Starting December 18, 2025, claims that meet the criteria below must be submitted directly to Anthem. This update removes the need to verify the member’s home address, enhancing claims filing efficiency. If you do not have a contiguous contract, this change will not affect you.
Claims that meet the following criteria must be submitted directly to Anthem:
- The member is an Anthem member.
- The care provider is located in a county that borders Anthem’s service area.
- Anthem’s contract covers the care provider’s contiguous county.
- Anthem’s contract includes the network that supports the member’s product (for example, Medicaid, PPO).
Note: The members’ residential address is no longer a criterion. To file directly with Anthem, all the above criteria must be fulfilled. Any other claims should be submitted to the local plan.
If you have any questions, contact Provider Services via the number on the back of our member ID card.
See original post here: https://providernews.anthem.com/kentucky/articles/claim-filing-update-for-contiguous-county-members-27866
